Delusional Disorder

Clinical Description

Delusional Disorder is a mental disorder characterized by the presence of one or more persistent delusions—strong beliefs that are contrary to reality.

Symptoms (Diagnostic Criteria)

  • Presence of one or more delusions
  • Schizophrenia criteria have never been met
  • Patient functioning is not markedly impaired, and behavior is not obviously bizarre
  • If mood episodes occur, they are brief compared to the duration of delusions

Types of Delusions

  • Persecutory delusions: The belief that one is being stalked, spied upon, conspired against, harmed, or harassed by other individuals or an organization.
  • Referential delusions: The belief that certain gestures, comments, environmental cues, and so forth are directed at oneself.
  • Grandeur delusions: The belief that one has exceptional abilities, powers, wealth, or fame.
  • Erotomanic delusions: The belief that another person (usually of fame or superior status) is in love with oneself.
  • Somatic delusions: Preoccupations with one's health and organ function.
  • Nihilistic delusions: The conviction that a major catastrophe will occur.
  • Jealous delusions: The belief that one's spouse or sexual partner is unfaithful without any concrete evidence.
  • Thought Withdrawal: The belief that one's thoughts have been "removed" by some outside force.
  • Thought Insertion: The belief that alien thoughts have been put into one's mind.
  • Delusions of Control: The belief that one's body or actions are being acted on or manipulated by some outside force.

Duration

Delusions persist for at least 1 month.

Age Onset and Age Requirement

  • Mean age of onset: 40 years old
  • Age range: 18 to 90 years

Treatments

Delusional Disorder is highly resistant to medication alone! A combination of therapy and medication is often required.

Medication

  • Antipsychotics – Reduce delusions and psychotic symptoms
  • Antidepressants – Address accompanying mood disturbances
  • Anxiolytics – Help with anxiety-related symptoms
  • Mood Stabilizers – Aid in emotional regulation

Psychotherapy

  • Cognitive Behavioral Therapy (CBT) – Helps challenge delusional thoughts
  • Individual Psychotherapy – Provides personal coping strategies
  • Family-Based Therapy – Supports education and guidance for loved ones
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